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	<title>M0服务对象临床观察表</title>
	
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<div style="border: 1px solid #AAAAAA;width: 70%;margin-bottom: 10px;padding: 5px;margin-top: 10px;">
	患者：<span id="spAnswerUser">${userName }</span><br/>
</div>

<div>
	
	<form id="frmqa54" class="easyui-form"  method="post" data-options="novalidate:true">
	<input type="hidden" name="openId" value="${openId}">
	<input type="hidden" name="questionnaireId" value="54">
	<h4>I.术前检查结果</h4>
	I1.血压 <input class="easyui-textbox" style="width:50px" id="question_189_3" name="question_189_3" required="required">/<input class="easyui-textbox" style="width:50px" id="question_190_3" name="question_190_3" required="required">mmHg<br/>
	I2.血红蛋白 <input class="easyui-textbox" style="width:76px" id="question_191_3" name="question_191_3" required="required">克/升<br/>
	I3.妇科检查<br>
	
	1)外阴
	<input id="question_192_1_520" name="question_192_1" type="radio" value="520" onclick="showDivQuestion('question_192_1','520')"><label for="question_192_1_520">未查</label>
	<input id="question_192_1_518" name="question_192_1" type="radio" value="518" onclick="showDivQuestion('question_192_1','518')"><label for="question_192_1_518">正常</label>
	<input id="question_192_1_519" name="question_192_1" type="radio" value="519" onclick="showDivQuestion('question_192_1','519')"><label for="question_192_1_519">异常</label>
	<div class="div_question_192_1_519" style="display:none;">
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_193_3" name="question_193_3"> 
	</div>
	<br/>
	2)阴道
	<input id="question_194_1_523" name="question_194_1" type="radio" value="523" onclick="showDivQuestion('question_194_1','523')"><label for="question_194_1_523">未查</label>
	<input id="question_194_1_521" name="question_194_1" type="radio" value="521" onclick="showDivQuestion('question_194_1','521')"><label for="question_194_1_521">正常</label>
	<input id="question_194_1_522" name="question_194_1" type="radio" value="522" onclick="showDivQuestion('question_194_1','522')"><label for="question_194_1_522">异常</label>
	<div class="div_question_194_1_522" style="display:none;">
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_195_3" name="question_195_3">
	</div>
	<br/>
	3)宫颈
	<input id="question_196_1_526" name="question_196_1" type="radio" value="526" onclick="showDivQuestion('question_196_1','526')"><label for="question_196_1_526">未查</label>
	<input id="question_196_1_524" name="question_196_1" type="radio" value="524" onclick="showDivQuestion('question_196_1','524')"><label for="question_196_1_524">正常</label>
	<input id="question_196_1_525" name="question_196_1" type="radio" value="525" onclick="showDivQuestion('question_196_1','525')"><label for="question_196_1_525">异常</label>
	<div class="div_question_196_1_525" style="display:none;">
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_197_3" name="question_197_3">
	</div>
	<br/>
	4)子宫
	<input id="question_198_1_529" name="question_198_1" type="radio" value="529"  onclick="showDivQuestion('question_198_1','529')"><label for="question_198_1_529">未查</label>
	<input id="question_198_1_527" name="question_198_1" type="radio" value="527"  onclick="showDivQuestion('question_198_1','527')"><label for="question_198_1_527">正常</label>
	<input id="question_198_1_528" name="question_198_1" type="radio" value="528"  onclick="showDivQuestion('question_198_1','528')"><label for="question_198_1_528">异常</label>
	<div class="div_question_198_1_528" style="display:none;"> 
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_199_3" name="question_199_3">
	</div>
	<br/>
	5)附件
	<input id="question_200_1_532" name="question_200_1" type="radio" value="532" onclick="showDivQuestion('question_200_1','532')"><label for="question_200_1_532">未查</label>
	<input id="question_200_1_530" name="question_200_1" type="radio" value="530" onclick="showDivQuestion('question_200_1','530')"><label for="question_200_1_530">正常</label>
	<input id="question_200_1_531" name="question_200_1" type="radio" value="531" onclick="showDivQuestion('question_200_1','531')"><label for="question_200_1_531">异常</label>
	<div class="div_question_200_1_531" style="display:none;">
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_201_3" name="question_201_3">
	</div>
	<br/>
	6)阴道分泌物
	<input id="question_202_1_535" name="question_202_1" type="radio" value="535" onclick="showDivQuestion('question_202_1','535')"><label for="question_202_1_535">未查</label>
	<input id="question_202_1_533" name="question_202_1" type="radio" value="533" onclick="showDivQuestion('question_202_1','533')"><label for="question_202_1_533">正常</label>
	<input id="question_202_1_534" name="question_202_1" type="radio" value="534" onclick="showDivQuestion('question_202_1','534')"><label for="question_202_1_534">异常</label>
	<div class="div_question_202_1_534" style="display:none;">
	,详述<input class="easyui-textbox" style="width:100px" type="text" id="question_203_3" name="question_203_3">
	</div>
	<br/>
	
	<br/>
	<h4>J.手术情况</h4>
	<strong>术前情况</strong><br/>
	J1.术前宫腔深度：<input class="easyui-textbox" style="width:100px" id="question_204_3" name="question_204_3">cm<br/>
	J2.麻醉情况：
	<input id="question_205_1_536" name="question_205_1" type="radio" value="536" onclick="showDivQuestion('question_205_1','536')"><label for="question_205_1_536">无</label>
	<input id="question_205_1_537" name="question_205_1" type="radio" value="537" onclick="showDivQuestion('question_205_1','537')"><label for="question_205_1_537">静脉麻醉</label>
	<input id="question_205_1_538" name="question_205_1" type="radio" value="538" onclick="showDivQuestion('question_205_1','538')"><label for="question_205_1_538">麻醉性镇痛药</label>
	<div class="div_question_205_1_538" style="display:none;">
	，详述<input class="easyui-textbox" style="width:100px" type="text" id="question_206_3" name="question_206_3">
	</div>
	<br/>
	
	<br/>
	<strong>吸引情况</strong><br/>
	J3.使用<input class="easyui-textbox" style="width:100px" id="question_207_3" name="question_207_3">号吸管<br/>
	J4.负压<input class="easyui-textbox" style="width:100px" id="question_208_3" name="question_208_3">mmH2O<br/>
	J5.吸引<input class="easyui-textbox" style="width:100px" id="question_209_3" name="question_209_3">次<br/>
	J6.吸出物：
	<input id="question_210_1_539" name="question_210_1" type="radio" value="539" onclick="showDivQuestion('question_210_1','539')"><label for="question_210_1_539">完整胚囊</label>
	<input id="question_210_1_540" name="question_210_1" type="radio" value="540" onclick="showDivQuestion('question_210_1','540')"><label for="question_210_1_540">破碎胎囊</label>
	<input id="question_210_1_541" name="question_210_1" type="radio" value="541" onclick="showDivQuestion('question_210_1','541')"><label for="question_210_1_541">其他</label>
	<div class="div_question_210_1_541" style="display:none;">
	，详述<input class="easyui-textbox" style="width:100px" type="text" id="question_211_3" name="question_211_3">
	</div>
	<br/>
	J7.术中出血量：
	<div style="display: inline-block;margin-left: 7px;">
		<input class="easyui-textbox" style="width:100px;" id="question_212_3" name="question_212_3">毫升
	</div><br/>
	J8.术后宫腔深度：<input class="easyui-textbox" style="width:100px" id="question_213_3" name="question_213_3">cm<br/>

	<br/>
	<strong>药物流产情况</strong><br/>
	J9.米非司酮总剂量：
	<div style="display: inline-block;margin-left: 8px;">
		<input class="easyui-textbox" style="width:100px" id="question_214_3" name="question_214_3">mg
	</div>
	<br/>
	J10.首次服药日期：
	<div style="display: inline-block;margin-left: 15px;">
		<input id="question_215_3" name="question_215_3" style="width: 100px;" type="text" class="easyui-datebox"/>
	</div>
	<br/>
	J11.前列腺素种类：
	<div style="display:inline-block;margin-left: 15px;">
		<input class="easyui-textbox" style="width:100px" id="question_216_3" name="question_216_3">
	</div>
	<br/>
	J12.前列腺素总剂量：
	<div style="display: inline-block;">
		<input class="easyui-textbox" style="width:100px" id="question_217_3" name="question_217_3">
	</div>
	<br/>
	J13.服药日期：
	<div style="display: inline-block;margin-left: 46px;">
		<input id="question_218_3" name="question_218_3" style="width: 100px;" type="text" class="easyui-datebox"/>
	</div>
	<br/>
	J14.留院观察期间胚囊是否排出：
	<input id="question_220_1_542" name="question_220_1" type="radio" value="542"><label for="question_220_1_542">排出</label>
	<input id="question_220_1_543" name="question_220_1" type="radio" value="543"><label for="question_220_1_543">部分排出</label>
	<input id="question_220_1_544" name="question_220_1" type="radio" value="544"><label for="question_220_1_544">完全未排出</label><br/>
	J15.是否发生不完全流产：
	<input id="question_221_1_545" name="question_221_1" type="radio" value="545"><label for="question_221_1_545">是</label>
	<input id="question_221_1_546" name="question_221_1" type="radio" value="546"><label for="question_221_1_546">否</label><br/>
	J16.是否清宫：
	<input id="question_222_1_549" name="question_222_1" type="radio" value="549"><label for="question_222_1_549">是，发生不完全流产</label>
	<input id="question_222_1_550" name="question_222_1" type="radio" value="550"><label for="question_222_1_550">是，本院药物流产后常规清宫</label>
	<input id="question_222_1_551" name="question_222_1" type="radio" value="551"><label for="question_222_1_551">否</label><br/>
	
	<br/>
	<h4>K.人工流产后即时放置IUD情况</h4>
	K1.放置节育器种类：<input class="easyui-textbox" style="width:100px" id="question_223_3" name="question_223_3"><br/>
	K2.放置是否顺利：
	<input id="question_224_1_552" name="question_224_1" type="radio" value="552" onclick="showDivQuestion('question_224_1','552')"><label for="question_224_1_552">顺利</label>
	<input id="question_224_1_553" name="question_224_1" type="radio" value="553" onclick="showDivQuestion('question_224_1','553')"><label for="question_224_1_553">不顺利</label>
	<div class="div_question_224_1_553" style="display:none;">
	，详述<input class="easyui-textbox" style="width:100px" type="text" id="question_225_3" name="question_225_3">
	</div>
	<input id="question_224_1_554" name="question_224_1" type="radio" value="554" onclick="showDivQuestion('question_224_1','554')"><label for="question_224_1_554">放置失败</label>
	<div  class="div_question_224_1_554" style="display:none;">
	，详述<input class="easyui-textbox" style="width:100px" type="text" id="question_226_3" name="question_226_3">
	</div>
	<br/>
	K3.术中/术后用药：<input class="easyui-textbox" style="width:100px" type="text" id="question_227_3" name="question_227_3"><br/>
	K4.填表人：<input class="easyui-textbox" style="width:100px" type="text" id="question_228_3" name="question_228_3" required="required">
	
	<c:if test="${btnShow == true}">
		<br/>
		<div align="center">
			<a id="btnSubmit" href="javascript:void(0)" onclick="submitFrm()" class="easyui-linkbutton" >提交</a>
			<a id="btnBack" href="javascript:void(0)" onclick="goback()" class="easyui-linkbutton" >返回</a>
			<input id="btnShow" type="hidden" value="true">
		</div>
	</c:if>
	
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